اﻧﺪازهﮔﯿﺮي اﺑﻌﺎد ﻧﺎﻣﺘﻘﺎرن در ﺟﻤﺠﻤﻪ اﻧﺴﺎن (ﯾﺎﻓﺘﻪ ﺟﺪﯾﺪ)

Measurements of Asymmetric Dimensions in Human Skull

زﻣﯿﻨﻪ و ﻫﺪف: ﻏﯿﺮﻗﺮﯾﻨﻪ ﺑﻮدن دو ﻧﯿﻤﻪ ﺟﻤﺠﻤﻪ، در ﺣﯿﻮاﻧﺎت و اﻧﺴﺎن اﻣﺮي ﺷﺎﯾﻊ اﺳﺖ. ﻣﻌﺎﯾﻨﻪ ﺑﺴﯿﺎري از ﺑﯿﻤﺎران و ﺑﺮرﺳﯽ ﻋﮑﺲﻫﺎي ﮔﺮﻓﺘﻪ ﺷﺪه از اﯾﺸﺎن در ﻃﯽ ﻋﻤﻞﻫﺎي ﺟﺮاﺣﯽ ﭘﻼﺳﺘﯿﮏ، ﻧﺸﺎن دﻫﻨﺪه ﻋﺮﯾﺾﺗﺮ ﺑﻮدن ﻧﯿﻤﻪ ﭼﭗ ﺑﯿﻨﯽ و ﺻﻮرت ﺑﻮده اﺳﺖ. ﭘﯿﺮو ﻣﺸﺎﻫﺪات، ﺑﺮ آن ﺷﺪﯾﻢ ﺗﺎ ﺑﺮاي رﺳﯿﺪن ﺑﻪ ﻧﺘﯿﺠﻪاي دﻗﯿﻖﺗﺮ، ﻣﻄﺎﻟﻌﻪاي ﺑﺮ اﻧﺪازهﮔﯿﺮي ﺟﻤﺠﻤﻪ اﻧﺴﺎن اﻧﺠﺎم دﻫﯿﻢ. ﻣﻮاد و روش ﻫﺎ: ﺑﺮاي ﺷﺮوع اﯾﻦ ﻣﻄﺎﻟﻌﻪ، 34 ﺟﻤﺠﻤﻪ ﻃﺒﯿﻌﯽ و در دﺳﺘﺮس از 3 داﻧﺸﮑﺪه ﭘﺰﺷﮑﯽ اﺳﺘﺎن ﺗﻬﺮان را ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار دادﯾﻢ. ﻋﮑﺎﺳﯽ اﺳﺘﺎﻧﺪاردي از رخ، ﻧﯿﻢ رخﻫﺎ و ﻧﻤﺎي ﻓﻮﻗﺎﻧﯽ ﺟﻤﺠﻤﻪﻫﺎ ﺑﻪ ﻋﻤﻞ آﻣﺪ. اﻧﺪازهﮔﯿﺮيﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰار Image J )ﻣﺆﺳﺴﻪ ﻣﻠﯽ ﺑﻬﺪاﺷﺖ(، ﺟﻬﺖ ﻣﻘﺎﯾﺴﻪ دﻗﯿﻖ ﻓﻮاﺻﻞ ﺛﺎﺑﺖ ﻋﻼﻣﺖﮔﺬاري ﺷﺪه، اﻧﺠﺎم ﺷﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﺑﺮرﺳﯽ اﺑﻌﺎد ﻣﺨﺘﻠﻒ دو ﻧﯿﻤﻪ راﺳﺖ و ﭼﭗ ﺑﺮ روي ﺟﻤﺠﻤﻪ ﻃﺒﯿﻌﯽ اﻧﺴﺎن، ﻧﺸﺎن دﻫﻨﺪه درﺟﺎﺗﯽ از ﻏﯿﺮ ﻗﺮﯾﻨﮕﯽ و ﻋﺪم ﺗﻘﺎرن ﺑﻪ ﻃﻮر ﺛﺎﺑﺖ ﻣﯽﺑﺎﺷﺪ. ﺑﯿﺸﺘﺮﯾﻦ ﺗﻔﺎوت در اﻧﺪازه اورﺑﯿﺖﻫﺎ ﺑﻮد. ﻓﻮاﺻﻞ ﺑﯿﻦ ﻧﻘﺎط ﻣﺸﺨﺺ در ﻗﺴﻤﺖ ﻓﻮﻗﺎﻧﯽ ﺧﺎرﺟﯽ اورﺑﯿﺖﻫﺎ PO)( ﺗﺎ ﺑﺮﺟﺴﺘﮕﯽ زاﯾﮕﻮن )ZY(، ﺧﻂ ﻋﻤﻮد ﺑﺮ ﻧﯿﻤﻪ ﺣﻔﺮه اورﺑﯿﺖ، ﺑﺮﺟﺴﺘﮕﯽ زاﯾﮕﻮن ﺗﺎ ﻗﺴﻤﺖ ﺗﺤﺘﺎﻧﯽ ﺑﯿﻨﯽ )SN(، و ﻣﺤﯿﻂ اورﺑﯿﺖﻫﺎ، ﺑﻪ ﻃﻮر ﻗﺎﺑﻞ ﺗﻮﺟﻬﯽ در ﺳﻤﺖ ﭼﭗ ﺑﺰرﮔﺘﺮ ﻣﯽﺑﺎﺷﻨﺪ. اﻧﺪازهﮔﯿﺮي ﻓﻮاﺻﻞ ﺑﯿﻦ ﮔﻮﻧﯿﻮن و ﭘﻮﮔﻨﯿﻮن در ﺟﻮاﻧﺐ، ﺗﻨﻪ ﻣﻨﺪﯾﺒﻮﻻر ﺳﻤﺖ راﺳﺖ را ﺑﺰرﮔﺘﺮ ﮔﺰارش ﮐﺮده اﺳﺖ، ﺣﺎل اﻧﮑﻪ اﻧﺪازهﮔﯿﺮي ﻫﻤﯿﻦ ﻧﻘﺎط از ﻧﻤﺎي ﻗﺪاﻣﯽ، ﻧﺸﺎن دﻫﻨﺪه ﻋﺮﯾﺾﺗﺮ و ﭘﻬﻦﺗﺮ ﺑﻮدن ﻧﯿﻤﻪ ﭼﭗ ﻣﯽﺑﺎﺷﺪ. ﺗﻔﺎوتﻫﺎي ﻗﺎﺑﻞ ﺗﻮﺟﻪ دﯾﮕﺮي در ﺳﺎﯾﺮ اﺑﻌﺎد ﺟﻤﺠﻤﻪ در ﺳﻤﺖ ﭼﭗ و راﺳﺖ ﯾﺎﻓﺖ ﻧﺸﺪ. ﻧﺘﯿﺠﻪ ﮔﯿـﺮي: ﻋﺪم ﺗﻘﺎرن ﭼﻬﺮه و ﺑﺪن ﯾﮏ ﻗﺎﻋﺪه اﺳﺖ، اﻣﺎ ﭘﯿﻮﺳﺘﮕﯽ و ارﺗﺒﺎط ﺑﯿﻦ اﯾﻦ ﻏﯿﺮ ﻗﺮﯾﻨﮕﯽ در دو ﺳﻤﺖ ﭼﭗ و راﺳﺖ، ﯾﺎﻓﺘﻪ ﺟﺪﯾﺪي اﺳﺖ ﮐﻪ در اﻧﺪازهﮔﯿﺮيﻫﺎي ذﮐﺮ ﺷﺪه، ﻧﺘﯿﺠﻪﮔﯿﺮي ﺷﺪه اﺳﺖ. ﯾﺎﻓﺘﻪﻫﺎي ﻣﺎ ﻧﺸﺎن ﻣﯽدﻫﺪ ﮐﻪ ﺣﻔﺮه اورﺑﯿﺖ، در ﻋﺮض، ارﺗﻔﺎع و ﻫﻤﭽﻨﯿﻦ ﻣﺤﯿﻂ، در ﺳﻤﺖ ﭼﭗ ﺑﻪ ﻃﻮر ﻗﺎﺑﻞ ﺗﻮﺟﻬﯽ ﺑﺰرﮔﺘﺮ اﺳﺖ، ﻫﻤﯿﻨﻄﻮر ﻃﻮل اﺳﺘﺨﻮان ﻣﻨﺪﯾﺒﻞ در ﺳﻤﺖ راﺳﺖ ﺑﻠﻨﺪﺗﺮ اﻣﺎ ﻋﺮض آن ﺑﺎرﯾﮏﺗﺮ ﻣﯽﺑﺎﺷﺪ. ﻫﺪف از اﻧﺠﺎم اﯾﻦ ﻣﺸﺎﻫﺪات، آﺷﻨﺎﯾﯽ ﺑﯿﺸﺘﺮ ﺑﯿﻤﺎران ﺑﺎ ﺗﻔﺎوتﻫﺎي آﻧﺎﺗﻮﻣﯿﮏ ﺑﺪن ﺧﻮد و ﻫﻤﭽﻨﯿﻦ اﯾﺠﺎد ﭼﺸﻢ اﻧﺪاز ﻣﺆﺛﺮﺗﺮي ﺑﺮاي ﺑﯿﻤﺎر و ﺟﺮاح ﺟﻬﺖ ﭘﯿﺶ ﺑﯿﻨﯽ، ﺑﺮﻧﺎﻣﻪرﯾﺰي و ﻧﺘﯿﺠﻪﮔﯿﺮي ﺑﻬﺘﺮ ﻣﯽﺑﺎﺷﺪ.

Introduction & Objective: Asymmetry of body and face is possessed in common between vertebrates especially in human. After years of plastic surgery practice and examining many patients, we noticed that there is a considerable occurrence of asymmetry among them. Most patients show the bigger left side of the face comparing to the right side. These findings lead us to do a more accurate study on natural human skulls. Materials & Methods: On thirty-four natural human skulls we marked cephalometric points, and took pictures from the anterior, both laterals and superior views, and did standard digital photography. We did exact measurements of 19 different distances between points, with the Image j software (National institute of health). Results: After comparing between left and right side measurements, we found out that the left orbit is longer and wider and also the left orbital area is bigger than right side. Measuring the lateral sides of the twenty completed skulls (including mandibles) showed that mandibular body is longer on the right side view but wider on the left side in the anterior view. Conclusions: Asymmetry and laterality of the face and body is a common rule between animals and humans. The correlation of this asymmetry between left and right sides in human skulls is our new finding. With this concept, both patients and surgeon will be aware of the natural anatomical variations and will have a better prediction of surgical outcome.